The dermatologist identity crisis: a phenomenological analysis of dermatology trainee professional identity during generalist redeployment.

Background: Dermatology faces a workforce crisis against a backdrop of wider medical education shifts towards generalism. A pivot towards generalism may have an impact on dermatology trainee professional identity, which, to our knowledge, has not been investigated and is known to have an impact on competence and conceptualization of ethics among physicians. Disruption because of the COVID-19 pandemic led to dermatology trainee redeployment and therefore presents a unique opportunity to examine dermatology trainee professional identity during times of pressure.

Medical abortion can be provided safely and effectively by pharmacy workers trained within a harm reduction framework: Nepal.

Objectives: To examine the treatment efficacy, safety and satisfaction of women using medical abortion (MA) pills provided by pharmacists following an education intervention based on a harm reduction approach.

Study Design: This was an operations research study over a six-month period in 2015, using a non-inferiority design. We provided training to dispense MA pills, based on a harm reduction approach, to a group of pharmacy workers in Makwanpur district (GROUP 2).

Preparedness of Foundation Year 1 doctors in dermatology.

Background: UK medical graduates are required to reach standards defined by the General Medical Council (in Tomorrows Doctors) in all specialties, including dermatology.

Aims: We assessed the self-reported competence of Foundation Year 1 (FY1) doctors in the diagnosis and management of skin disease correlated against their undergraduate dermatology experience.

Methods: The FY1 doctors attending a teaching programme were surveyed at six hospital sites throughout the North Western Deanery.

Nonhealing vegetating plaque on the finger: tuberculosis verrucosa cutis.

Tuberculosis verrucosa cutis is an uncommon form of tuberculosis that typically presents as a chronic warty plaque. It develops in individuals with moderate to high immunity to Mycobacterium tuberculosis due to inoculation of an open wound. We present the case of a Somali man born in the United Kingdom who presented with a nonhealing ulcer on the right hand of 10 years' duration.

The use of retinoids in the treatment of photoaging.

Photoaging describes the clinical and histologic consequences of chronic sun exposure, the key features of which--wrinkles and mottled hyperpigmentation--are frequently and erroneously attributed to the aging process. Although a number of surgical procedures can improve the clinical appearance of photoaged skin, the only medical therapy with proved benefit derived from randomized clinical trial evidence is the use of topical retinoids, particularly tretinoin, isotretinoin, and tazarotene. Retinoids are capable not only of repairing photoaged skin at both the clinical and biochemical levels but their use may prevent photoaging.

Impaired Langerhans cell migration in psoriasis.

We have examined whether psoriasis is associated with systemic effects on epidermal Langerhans cell (LC) function and, specifically, the migration of LCs from the skin. Compared with normal skin, the frequency and morphology of epidermal LCs in uninvolved skin from patients with psoriasis was normal. However, mobilization of these cells in response to stimuli that normally induce migration (chemical allergen, tumor necrosis factor alpha [TNF-alpha], and interleukin-1beta [IL-1beta]) was largely absent, despite the fact that treatment with TNF-alpha and IL-1beta was associated with comparable inflammatory reactions in patients and controls.